An outbreak of listeria that contributed to the deaths of three people has been traced to a second production facility operated by Blue Bell Ice Cream.

Blue Bell spokesman Gene Grabowski said Tuesday that a contaminated 3-ounce cup of ice cream was traced to a plant in Broken Arrow, Oklahoma. Ten products recalled earlier this month by the company were traced to a production line at a plant in Brenham, Texas, where the company is based.

The recall began when five patients at Via Christi St. Francis hospital in Wichita, Kansas, became ill with listeria while hospitalized. Officials determined at least four drank milkshakes that contained Blue Bell ice cream. Three of the patients later died.

The contaminated 3-ounce cup was found at the hospital.

The U.S. Centers for Disease Control reports that all five people were hospitalized at the same hospital for unrelated problems before developing invasive listeriosis—a finding that strongly suggests their infections were acquired in the hospital.

Three deaths were reported among these five patients.

Of the four ill people for whom information is available on the foods eaten in the month before Listeria infection, all four consumed milkshakes made with a single-serving Blue Bell brand ice cream product called “Scoops” while they were in the hospital.

The Kansas Department of Agriculture’s (KDA) laboratory isolated Listeria monocytogenes from a previously unopened, single-serving Blue Bell brand 3 oz. institutional/food service chocolate ice cream cup obtained in March 2015 from the hospital associated with this outbreak.

On March 23, 2015, Blue Bell Ice Cream of Brenham, Texas, announced a recall of 3 oz. institutional/food service ice cream cups (with tab lids) of the following flavors: chocolate, strawberry, and vanilla.

CDC recommends that consumers do not eat recalled products and that institutions and retailers do not sell or serve them.

Investigation into whether other products were produced on the same line as the 3 oz. institutional/food service ice cream cups is ongoing, and new information will be provided as it becomes available.

Listeria monocytogenes was previously isolated from the following Blue Bell brand ice cream products collected from Blue Bell Creameries facilities in Texas, South Carolina, or both in 2015: ice cream Scoops, Chocolate Chip Country Cookie Sandwiches, and Great Divide Bars.

Whole genome sequences of Listeria monocytogenes strains isolated from these ice cream products were highly related to sequences of Listeria strains isolated from four patients in this outbreak.

Blue Bell Creameries reported that these products were removed from the market in March 2015. However, contaminated ice cream products may still be in the freezers of consumers, institutions, and retailers.

Three people are dead and two sick, all from the same hospital in Kansas and linked to Blue Bell Scoops milkshakes and the company publishes this on its website: “For the first time in 108 years, Blue Bell announces a recall” (right, exactly as shown).

Way to go with the empathy.

Several government agencies have announced the outbreak, saying patients became ill with listeriosis after hospitalizations for unrelated causes at the same hospital. They became ill between January 2014 and January 2015 after a majority were known to have consumed Blue Bell Creameries ice cream at the hospital.

The outbreak was recently discovered after two patients were identified with the same strain of listeriosis. Further investigation identified three other patients with listeriosis who had been hospitalized for unrelated causes before the onset of listeriosis.

Of the four ill people for whom information is available on the foods eaten in the month before Listeria infection, all four consumed milkshakes made with a single-serving Blue Bell brand ice cream product called “Scoops” while they were in the hospital.

The five patients who were treated in a single hospital in Kansas were infected with one of four rare strains of Listeria monocytogenes. Three of these strains, which are highly similar, have also been found in products manufactured at the Blue Bell Creameries production facility in Brenham, Texas.

FDA was notified that these three strains and four other rare strains of Listeria monocytogenes were found in samples of Blue Bell Creameries single serving Chocolate Chip Country Cookie Sandwich and the Great Divide Bar ice cream products collected by the South Carolina Department of Health & Environmental Control during routine product sampling at a South Carolina distribution center, on February 12, 2015. These products are manufactured at Blue Bell Creameries’ Brenham facility.

The Texas Department of State Health Services, subsequently, collected product samples from the Blue Bell Creameries Brenham facility. These samples yielded Listeria monocytogenes from the same products tested by South Carolina and a third single-serving ice cream product, Scoops, which is also made on the same production line.

The Blue Bell brand ice cream products with tests showing Listeria monocytogenes were ice cream Scoops, Chocolate Chip Country Cookie Sandwiches, and Great Divide Bars.

Today, the U.S. Food and Drug Administration warned consumers about the potential contamination in Blue Bell Creameries’ products. Kansas health officials are warning consumers who have purchased the following Blue Bell Creameries novelty items and have not consumed the items to discard them:

Chocolate Chip Country Cookie

Great Divide Bar

Sour Pop Green Apple Bar

Cotton Candy Bar

Scoops

Vanilla Stick Slices

Almond Bar